tbuckley/cabot-search huggingface dataset:
AB0792 ADULT-ONSET IGA VASCULITIS WİTH RENAL INVOLVEMENT
Authors: F. Yildirim, M. E. Kutu, Y. Çalik, S. Çelik, C. Bes
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic Immunoglobuline A vasculitis (IgAV) often presents glomerulonephritis accompanying palpable purpura. Unlike children, renal involvement can be severe in adults. Especially, in the chronic period, renal involvement determines the prognosis. A significant proportion of the patients initially have pathological renal findings, while pathological renal findings may occur later in some patients. <h3>Objectives</h3> It was aimed to compare the clinical features of patients with renal involvement at the beginning and those with subsequent renal involvement, to determine the predictors of renal involvement and to determine the factors affecting renal prognosis. <h3>Methods</h3> A total of 42 adult patients with IgA vasculitis nephritis with followed between January 2018 and August 2022 in two tertiary hospitals were included in the study. The patients were divided into 2 groups as those with and without IgA vasculitis nephritis findings at the beginning. Patients' clinical and laboratory data were collected at baseline and at follow-up. and were analyzed retrospectively. <h3>Results</h3> Thirty (%71) of 42 patients had signs of IgA vasculitis nephritis at baseline and 12 (%29) patients, signs of nephritis appeared later. The median time between first visit and development of nephritis was 18 [IQR:6-44] days in patients whose nephritis findings appeared later. In the binary logistic regression analysis, it was determined that gastrointestinal involvement at the baseline predicted the later development of renal involvement [OR:9,399, 95% CI=1,800-49,079, p = 0,009]. Comparative results of the 2 groups with and without IgA vasculitis nephritis findings at baseline in terms of clinical features are presented in Table 1. <h3>Conclusion</h3> A significant proportion of patients with IgA vasculitis who do not have pathological renal findings at baseline may appear glomerulonephritis findings in the later follow-up period. Clinicians should be careful in terms of renal involvement. Similar to previous studies, our study revealed that gastrointestinal involvement is a risk factor for renal involvement.(1,2) Patients with initial gastrointestinal symptoms but no pathological renal findings should be followed more frequently and regularly. <h3>References</h3> [1]Chan H, Tang Y-L, X-H Lv et al. Risk Factors Associated with Renal Involvement in Childhood Henoch-Schönlein Purpura: A Meta-Analysis. PLoS One. 2016 Nov 30;11(11):e0167346. doi: 10.1371/journal.pone.0167346. [2]Sano H, Izumida M, Shimizu H et al. Risk factors of renal involvement and significant proteinuria in Henoch-Schonlein purpura. Eur J Pediatr (2002) 161: 196–201 DOI 10.1007/s00431-002-0922-z. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0788 FLOW CYTOMETRY ANALYSIS OF IMMUNE CELLS IN PATIENTS WITH BEHCET’S SYNDROME: A REAL-WORLD STUDY IN CHINA
Authors: J. LI, F. Sun, W. Zhou, T. Liu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Behcet's syndrome (BS) is an autoimmune disease characterized by recurrent mucocutaneous ulcerations, vascular and nervous system involvement. While there have been a lot of researches proving that immune cells play a vital role in rheumatic disease, opinions on the effect of different immune cell subsets on BS is inconsistent. Therefore, we performed this real-world study to explore the role of immune cells in the pathogenesis of BS. <h3>Objectives</h3> To investigate the changes in the levels of several immune cell subsets in BS, and the correlation between the levels of different immune cell subsets and clinical features in patients with BS. <h3>Methods</h3> This is a retrospective, single-center study conducted in Beijing. 136 patients diagnosed with BS in rheumatology and immunology department of Peking University People's Hospital from 2018 to 2021 and 114 healthy controls (HCs) were enrolled. All patients met the International Criteria for Behcet's Disease (ICBD). We utilized flow cytometry to test the levels of CD4<sup>+</sup> T cells, CD8<sup>+</sup> T cells, B cells, NK cells and several subsets of CD4<sup>+</sup> T cells. Wilcoxon rank test and student's <i>t</i>-test were used and a P-value &lt;0.05 was considered statistically significant. <h3>Results</h3> Compared to HCs, there is a decrease in the count of CD4<sup>+</sup> T cells, B cells and NK cells in BS patients. A significant increase in the frequency of IFN-γ, IL-2 and IL-4 producing CD4<sup>+</sup> T cell in BS patients were observed, which accompanied by a decreased frequency of Naïve CD4<sup>+</sup>T cells. The frequency of Foxp3<sup>+</sup> Treg cells was notably increased while the proportion of CLA<sup>+</sup> Treg in Treg cells was significantly decreased in BS patients. BS patients' frequency of follicular helper T cells were apparently lower than HCs. There was a significant reduction of the frequency of Treg in patients with vascular involvement. The frequency of follicular helper T cells were positively correlated with joint involvement and negatively correlated with nerve involvement in BS patients. Patients with gastrointestinal involvement had a increased frequency of TNF-α, IFN-γ, IL-2 and IL-4 producing CD4<sup>+</sup> T cells and a decreased level of B cell count. Elevated level of NK cell count and decreased frequency of TNF-α, IL-2 producing CD4<sup>+</sup> T cells were found in patients with skin-mucosa involvement alone. <h3>Conclusion</h3> Our study confirmed that Th1 cells, Th2 cells, Treg cells, follicular helper T cells, B cells and NK cells contribute a lot to the pathogenesis of BS. <h3>References</h3> [1]Yazici, Y., Hatemi, G., Bodaghi, B., Cheon, J. H., Suzuki, N., Ambrose, N., &amp; Yazici, H. (2021). Behçet syndrome. <i>Nature reviews. Disease primers</i>, <i>7</i>(1), 67. https://doi.org/10.1038/s41572-021-00301-1 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0797 ABSTRACT TITLE: OCULAR INVOLVEMENT AS AN INITIAL PRESENTATION IN SYSTEMIC VASCULITIS: AN OBSERVATIONAL STUDY
Authors: R. H A Mohammed, D. Hassan Attia
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic Vasculitides are a heterogenous group of immune mediated vascular inflammatory pathologies that contributes to vessel wall necrosis and damage. Ocular manifestation with systemic vasculitides isn't uncommon as an initial presentation. Identifying the patterns of ocular involvement associated with a specific diagnosis of vasculitis might guide the diagnosis at early encounter, while if underdiagnosed or improperly treated might contribute to devastating complications <sup><b>[1-3]</b></sup>. <h3>Objectives</h3> to survey the patterns of ocular manifestations as the initial presentation in a population of patients with systemic vasculitides. <h3>Methods</h3> This is an observational cohort study in which data regarding ocular involvement were retrieved from medical records. The inclusion criteria: medical records of adult patients &gt; 18 years with the diagnosis of any form of vasculitis according to the internationally recognized criteria having ocular involvement as confirmed by an expert ophthalmologist. Exclusion Criteria: patients with additional diagnosis whether endocrinal, metabolic, neoplastic and infectious diseases. <h3>Results</h3> The study included a total of 328 patients with the different diagnoses of vasculitis (68.9% males and 31.1% females, their mean ages were 38.58± 11.96 years, mean disease duration of 65.35±75.84 months). Figure 1 Ocular involvement was reported in 46% of the included cases with vasculitis at initial encounter, uveitis was diagnosed in 31.1% (7.3% anterior uveitis, 10.7% posterior uveitis, 13.1% pan uveitis), optic neuritis in 3.5%, retinal vasculitis in 17%, retinal artery thrombosis was reported in 1.8%, retinal vein thrombosis in 5.4%, orbital pseudotumor in one patient with granulomatosis with polyangiitis, scleritis one patient and episcleritis one patient with granulomatosis with polyangiitis. Ocular involvement was found in 61.3% of cases with BD (uveitis in 48.2%, retinal vasculitis in 18.4) at initial encounter with uveitis being the most common. <h3>Conclusion</h3> The patterns of ocular involvement at initial presentation might guide the diagnosis of one form of vasculitis over the other especially with incomplete forms. <h3>References</h3> [1]Macarie SS, Kadar A. Eye involvement in ANCA positive vasculitis. Rom J Ophthalmol. 2020 Jan-Mar;64(1):3-7. [2]Papaliodis, George N. Ophthalmologic manifestations of systemic vasculitis. Current Opinion in Ophthalmology, Nov 2017 28(6): p 613-616. [3]Özdal, P.Ç., Tugal-Tutkun, I. Choroidal involvement in systemic vasculitis: a systematic review. J Ophthal Inflamm Infect 12, 14 (2022). <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0733 CONCORDANCE BETWEEN THE 1990 ACR CLASSIFICATION CRITERIA AND THE NEW 2022 ACR/EULAR 2022 CRITERIA IN GIANT CELL ARTERITIS
Authors: J. Sanchez-Martin, J. Medina-Del Valle, J. Loricera, M. F. Garcia-Reija, R. Blanco
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Classification criteria for vasculitis, including giant cell arteritis (GCA) are under constant revision. In 2022, the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria were presented, renewing those published by ACR in 1990. They include wider range of clinical criteria and imaging tests, such as ultrasonography (US) and Positron emission tomography (PET), which has contributed to the diagnosis of a higher number of cases. <h3>Objectives</h3> To assess the concordance between recent 2022 ACR/EULAR giant cell arteritis classification criteria and the criteria of ACR 1990 <b>[1,2].</b> <h3>Methods</h3> Observational study of patients diagnosed with GCA who underwent temporal artery biopsy (TAB) between 2016 and 2022 in an university hospital. Concordance between both sets of criteria were analyzed with Cohen's kappa index. <h3>Results</h3> We present 191 patients (120 female/71 male) (mean±SD; 75±10 years). The main characteristics of the patients are shown in <b>Table 1</b>. The Kappa index between both criteria weighted by prevalence and bias was 0.654 (moderate-high degree of agreement). Global agreement of 83% was observed, with a higher specific agreement for negative results (88%) than for positive results (67%). Disagreement was observed in 16% of patients who were considered negative for ACR 1990 criteria but positive for ACR/EULAR 2022 criteria and in 2% who were considered positive for ACR 1990 criteria but negative for ACR/EULAR 2022. 2022 ACR/EULAR showed a higher sensitivity, and 27 additional patients were classified as GCA with these classification criteria. <h3>Conclusion</h3> Moderate-high concordance was found between 2022 ACR/EULAR and 1990 ACR classification criteria. However, the 2022 ACR/EULAR criteria consider a wider range of factors than the 1990 ACR criteria by introducing US and PET findings, thus increasing sensitivity and allowing a larger number of patients to be diagnosed. Cranial GCA was the most frequent phenotype observed. <h3>References</h3> [1]Ponte C, et al. Arthritis Rheumatol. 2022. PMID: 36350123 [2]Hunder GG, et al. Arthritis Rheum. 1990. PMID: 2202311 <h3>Disclosure of Interests</h3> None Declared.
AB0688 QUALITY INDICATORS AND SATISFACTION WITH CARE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: G. Serna-Peña, J. A. Esquivel Valerio, G. García-Arellano, L. R. Aguilar Rivera, R. D. J. Castillo de la Garza, A. A. De León Pérez, E. Aguilar Rivera, C. E. Vázquez Pérez, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Quality indicators (QI) for patients with SLE were developed based on the 2019 EULAR recommendations [1]. Measuring quality of care (QOC) may provide recognition of gaps and challenges in clinical practice. Improving QOC may relate to high satisfaction with care. Satisfaction might be considered a valuable indicator to measure the success of provided care. Evidence about the relationship between quality of care and satisfaction perceived by SLE patients is scarce. <h3>Objectives</h3> To correlate adherence to QIs based on the 2019 EULAR recommendations and satisfaction with care in SLE patients. <h3>Methods</h3> We conducted a cross-sectional and retrospective study in a Lupus Clinic in Northeast Mexico. We included patients at least 18 years old who met the ACR/EULAR 2019 classification criteria for SLE. Consecutive patients were interviewed by the researchers on their last visit to assess the adherence to quality indicators developed by Chavatza et. al., based on 2019 EULAR recommendations. Medical records were revised to assess demographic data, disease activity, treatment, organ involvement, and cumulative damage. Adherence was achieved if the patient met all components of the QI. We calculated adherence as the number of fulfilled patients divided by the number of eligible patients per indicator. Satisfaction with care was evaluated with the satisfaction domain of the LupusPRO 1.7 version. The distribution was assessed with Kolmogorov-Smirnov. The Spearman correlation coefficient was obtained to determine the relationship between quality of care and satisfaction with care. <h3>Results</h3> Seventy patients were included with a median age of 33 (IQR, 23-48), and 90% were female. Global adherence to the 18-QIs and Satisfaction with Care score revealed no correlation using the Spearman correlation coefficient (r = 0.064, p= 0.599). Overall adherence was 62.29%. The median satisfaction with care was 100. The results of each indicator are shown in Table 1. <h3>Conclusion</h3> In conclusion, we did not find a correlation between satisfaction with care and QOC. The areas of quality of care that performed the lowest were the measurement of the SLEDAI-2K and the SLICC/ ACR damage index, which was an area of opportunity for improvement. <h3>References</h3> [1]Chavatza, K., et al., <i>Quality indicators for systemic lupus erythematosus based on the 2019 EULAR recommendations: development and initial validation in a cohort of 220 patients.</i> Ann Rheum Dis, 2021. <b>80</b>(9): p. 1175-1182. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0678 INTERLEUKIN-18 AS A PREDICTOR OF SUBCLINICAL CARDIOVASCULAR AFFECTION AND DISEASE ACTIVITY IN SYSTEMIC LUPUS PATIENTS
Authors: S. A. A. Tabra, M. H. Abu-Zaid, D. Maria, R. Elsharaby
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which has variable clinical manifestations and causes severe organ damage <sup>(1)</sup>. Interleukin-18 (il-18) is a pro-inflammatory cytokine which plays a key role in many inflammatory and cardiovascular diseases <sup>(2)</sup>. <h3>Objectives</h3> Evaluation of plasma level of IL-18 in SLE patients and correlate it with the subclinical cardiovascular affection and disease activity. <h3>Methods</h3> Thirty lupus patients (G I), and 30 healthy age and sex matched volunteers as control group (G II) were recruited for this case control study. All participants were subjected to complete history taking and clinical assessment, lupus disease activity was measure using SLE disease activity index 2000 (SLEDAI-2K), Serum IL-18 level, CRP, C3, C4, anti dsDNA, and lipid profiles were measured. Cardiovascular assessments were done using echocardiography, flow mediated dilatation of the brachial artery (FMD), and carotid intima-media thickness (cIMT). Plasma levels of IL-18 were measured and correlated with different parameters. <h3>Results</h3> There were no significant differences between the patients and controls regarding demographic data (P&gt;0.05). The mean SLEDAI-2K was 3.5±2.1. The mean plasma level of IL-18 was 432.85±165.37 pg/ml in lupus patients, while IL-18 was 195.65±82.91 pg/ml in healthy volunteers, there was significant elevation of il-18 level in lupus patients in comparison with controls. There were significantly lowering levels of C3, &amp; C4 in lupus patients. Regarding cardiovascular assessment; SLE patients showed significantly higher lipid profile, &amp; cIMT measures and revealed lower FMD as well as detecting echocardiographic abnormalities compared to controls. (These date were summarized in Table 1). Serum IL-18 was positively correlated with cIMT and SLEDAI-2K, also IL-18 was negatively correlated with FMD, C3 &amp; C4. <h3>Conclusion</h3> IL-18 was an independent predictor of cardiovascular events in SLE patients, also it was correlated with lupus activity. <h3>References</h3> [1]Mosaad, G.M., Abdel moneam, S.M., Soliman, A.F. <i>et al.</i> (2022): Implication of plasma gelsolin in systemic lupus erythematosus patients. <i>Egypt Rheumatol Rehabil</i> 49, 1. [2]Formanowicz, D., Wanic-Kossowska, M., Pawliczak, E. <i>et al.</i> (2015): Usefulness of serum interleukin-18 in predicting cardiovascular mortality in patients with chronic kidney disease – systems and clinical approach. <i>Sci Rep</i><b>5</b>, 18332. <h3>Disclosure of Interests</h3> None declared
AB0721 CHARACTERISTICS AND LONG-TERM OUTCOME OF DISEASE PHENOTYPES IN TAKAYASU ARTERITIS WITH SUPRA-AORTIC INVOLVEMENT
Authors: Y. Sun, L. Wang, H. Chen, X. Dai, L. Ma, X. Kong, L. Jiang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Supra-aortic involvement was most commonly seen in Takayasu arteritis (TA), ranging from 40% to 84%. [1, 2]. The clinical manifestations were heterogeneous and prognosis differed greatly in TA with supra-aortic involvement [3, 4]. <h3>Objectives</h3> To explore the characteristics and long-term outcomes in different phenotypes of the East China Takayasu arteritis (ECTA) cohort with supra-aortic involvement. <h3>Methods</h3> Patients with supra-aortic involvement were enrolled from the ongoing ECTA cohort from July 2009 to December 2021 and followed up until June 30, 2022. Patients were assigned to four phenotypes: asymptomatic (AS), constitutional symptoms (CSs), vascular-associated symptoms (VASs), and neurological severe ischemic events (SIEs). Pattern differences in clinical features were analyzed, and the cumulative incidence of severe adverse events (SAEs) was evaluated. We performed multiple logistic regression analysis to compare the phenotypes. <h3>Results</h3> Six hundred fifty-seven TA patients with supra-aortic involvement were included: 54 (8.2%), 72 (11.0%), 303 (46.1%), and 228 (34.7%) patients with AS, CSs, VASs, and neurological SIEs, respectively. Compared to other phenotypes, CSs had significantly higher levels of inflammatory indicators. Neurological SIEs experienced poor treatment response including lower 6-month clinical remission rate and higher drug change rate. The median follow-up period was 3.0 (1.5–13.3) years. The 5-, and 10-year cumulative SAEs incidence rates in neurological SIEs (26.0% [18.7–32.1%], and 61.5 % [30.3–78.7%]) were significantly higher than those in other patients (Figure 1). The occurrence of SAEs was 5.9 folds (3.4–10.1; p &lt; 0.001) in patients with neurological SIEs history compared with that in those without neurological SIEs history. <h3>Conclusion</h3> Our findings provide new insights into the characteristics and prognosis of different phenotypes in TA with supra-aortic involvement, which may be critical for early detection strategies and stratification management of heterogeneous diseases. <h3>References</h3> [1]Wang L, Sun Y, Dai X, et al. Carotid Intima-media Thickness/Diameter Ratio and Peak Systolic Velocity as Risk Factors for Neurological Severe Ischemic Events in Takayasu Arteritis. <i>J Rheumatol</i> 2022; 49: 482-8. [2]Cong XL, Dai SM, Feng X, et al. Takayasu's arteritis: clinical features and outcomes of 125 patients in China. <i>Clin Rheumatol</i> 2010; 29: 973-81. [3]Comarmond C, Biard L, Lambert M, et al. Long-term outcomes and prognostic factors of complications in Takayasu arteritis: a multicenter study of 318 patients. <i>Circulation</i> 2017; 136: 1114-22. [4]Mirouse A, Biard L, Comarmond C, et al. Overall survival and mortality risk factors in Takayasu's arteritis: a multicenter study of 318 patients. <i>J Autoimmun</i> 2019; 96: 35-9. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0636 FREQUENCY OF TROPICAL INFECTIONS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS IN A MEDIUM INCOME COUNTRY, USING DATA ANALYTICS TECHNIQUES
Authors: A. Beltrán-Ostos, S. Moreno, J. S. Castro Villarreal, C. F. Valencia Arboleda
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The co-occurrence of lupus (SLE) and tropical infections has been poor studied, this group of infections, prevalent in the tropics could simulate or trigger disease activity, however, some studies suggest that malaria infection could confer protection from the development of SLE, that is for this reason, studies are required to characterize this population. <h3>Objectives</h3> The objective of our study was to estimate de frequency of tropical infections in patients with SLE using administrative databases in Colombia. <h3>Methods</h3> This study was carried out using databases generated based on technical studies conducted by the Colombian Ministry of health. For the present study, databases provided contained information from 2014 to 2017, and contains the information of approximately 20 million affiliates. A person in the database was considered a patient with SLE if she met the following operative definition: a patient who has been classified with an ICD-10 diagnosis code which corresponds to SLE in an inpatient claim or if she has been classified at least two times in outpatient claims, with a difference of minimum 30 days and less than 2 years, with a ICD-10 diagnosis code corresponding to SLE. In turn, a control group matched by age and sex was randomly selected to evaluate the difference in the frequency of tropical infections in both groups. The variables considered in this part of the study were classified in two main groups: demographic, and clinical. Demographic variables include age, sex, and department (territorial entity). As for tropical infections we use the ICD-10 diagnosis code and to estimate the prevalence of tropical infections. <h3>Results</h3> Using the operative definition of SLE, 5527 patients were selected, and 22108 controls paired by sex and age, the average age was 43 years old in both groups, the frequency of tropical infections was low in both groups, however, we documented a higher frequency of malaria and dengue in the group of subjects with SLE when compared to controls. <h3>Conclusion</h3> SLE patients had similar frequency of tropical infections compared to matched controls, except for malaria and dengue infections. <h3>Reference</h3> [1]Yasri, S., &amp; Wiwanitkit, V. (2015). Dengue and lupus: The problem of co-occurrence. <i>Asian Pacific Journal of Tropical Disease</i>, <i>5</i>(12), 1007–1008. https://doi.org/10.1016/S2222-1808(15)60974-4 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.